Session Design Submission Review

Yes

• Assessment, Curriculum, and Evaluation
• Graduate Surgical Education

The American Board of Surgery has mandated use of Entrustable Professional Activities (EPAs) in the assessment of general surgery residents since July 2023. EPAs compose a competency-based education (CBE) assessment framework that has been increasingly adopted across medical specialties as a workplace-based assessment tool. EPAs focus on directly observed behaviors to determine the level of entrustment a trainee has for a given activity of that specialty. Limited and emerging evidence of EPAs in general surgery has provided initial validity for their use. EPAs represent a current and significant shift in the evaluation of surgical residents as part of the overarching progression toward competency-based education among residency programs.

Nationwide implementation of EPA adoption and use has presented challenges across levels and stakeholders, including program directors, program coordinators, trainees, and front-line faculty. A first step in evaluating use and impact of EPAs on surgical education is to understand the initial implementation and, critically, perceived barriers experienced by stakeholders who have used this tool. Our objective is to investigate and describe the initial implementation and use of EPAs by general surgery programs and suggest tools, resources, and methods for overcoming initial barriers and obstacles.

Broadly, this panel of speakers will share challenges experienced at diverse programs and methods used to overcome them. We enlisted the perspective of various program types, including smaller community and larger academic institutions, as well as an overview of perspectives, including faculty, resident, and coordinator. We expect this session to be beneficial for educational leadership (e.g. Program Directors), general teaching faculty, residents, and program coordinators or managers. Although initially adopted by general surgery, this session should be useful across surgical specialties as this type of CBE continues to expand across surgical specialties.

This session will first provide an initial background on EPA implementation and use in general surgery for a broader audience, including background for adoption, logistics of implementation and use, and initial perceived obstacles. To this end, a survey of faculty and trainees (residents) was created to determine perceived barriers to using the EPAs. Introduction of this topic will also present initial findings from these surveys with suggested barriers and obstacles for discussion.

Critically, this session will also host four representatives who have experience with the implementation and use of EPAs at their program, including a faculty member from a smaller community program, a faculty member from a larger academic program, a resident, and a coordinator.

This collaborative, mixed-methods approach to understanding and exploring the impact of EPAs on surgical education will be of value to many members and attendees of ASE. After this session, attendees will be able to take home strategies to develop infrastructure for EPAs, enhance use of EPAs at their home program, understand barriers to initial implementation and use, and overcome those barriers via resources, tools, and ‘best practices.’

In this 60 minute panel, there will be a brief introduction by moderators from the ACE (Tasha Posid) and GSE (Kshama Jaiswal) committee to introduce the topic and importance, as well as a brief overview results from the ACE/GSE survey on EPA implementation.  This will be followed by 10-minute presentation for each panelist, followed by approximately 15 minutes for Q&A, lead by discussants Jenny Guido, Lisa Cunningham and Emily Huang.

1. Recognize the challenges to EPA implementation

2. Develop solutions to the challenges of EPA implementation

3. Differentiate the challenges and solutions based on program type and setting